Background: Advances in technology and life-sustaining interventions afford patients access to a wider network of subspecialized care through inter-facility transfers. Implicit in these transfers are multiple complex steps that leave patients vulnerable to adverse events. The few guidelines that exist regarding the inter-facility transfer process focus on critically-ill or surgical patients, and emphasize pre-transfer communication [...]

Background: Our single academic medical center implemented a standardized Outside Hospital (OSH) communication process, encouraging physician completion of a dedicated templated patient transfer note for admission to any Department of Medicine (DOM) specialty. Prior outcomes analysis revealed that documentation with any transfer note, templated or non-templated, is significantly associated with improved outcomes of death within [...]

Background: Outside Medical Records are essential for accurate continuity of care when patients are transferred from one healthcare system to another. Despite their importance, obtaining records in a timely manner is a notoriously difficult process. At Stanford Hospital, the medicine teams were burdened with 5 pages of paperwork per record request for a single patient. [...]

Background: Interhospital transfer (IHT) is intended to improve access to specialized therapies, maintain continuity of care, or care concordant with patients’ wishes; however, it is correlated with higher costs, longer length of stay, and greater mortality for many patients, even after illness severity adjustment (1-5). A better understanding of frontline providers’ reasons to accept transfer [...]

Background: Interhospital transfer is a necessary part of patient care in an increasingly complex healthcare environment. However, it is an ill-defined process that has been associated with increased mortality, cost, and length of stay, even after disease severity adjustment. Purpose: We aim to describe the triage process for interhospital transfer requests at a large, urban [...]

Background: At academic institutions and other referral centers the process of accepting transfers from other hospitals has been a challenging and potentially laborious process to coordinate smoothly. It was also one that was not previously reimbursable. However, beginning in 2017 Medicare and other insurance companies began reimbursing Non-Face-to-Face Prolonged services procedural codes. These new codes [...]

Background: Interhospital transfer (IHT) processes vary across institutions. The fragmented and complex nature of IHTs pose patient safety risks. The implementation of a standardized IHT process with a templated note for hospital medicine patients at our institution demonstrated promising patient safety outcomes and a significant increase in physician satisfaction. A second, iterative intervention expanded this [...]

Background: Outside-hospital (OSH) transfers are crucial to providing patients with a higher level or more specialized care. Despite the intent to improve care, OSH transfers are associated with negative outcomes due to miscommunication, lack of information, and other factors affecting patient care. Currently, there is no widely standardized process for OSH transfers. Studies show that [...]